Use of CNTF (ciliary neurotrophic factor) receptor activators for the treatment of obesity

ABSTRACT

The present invention refers to the use of hCNTF (human ciliary neurotrophic factor), mutants thereof or other molecules that activate the CNTF receptor, for the preparation of drugs for the treatment of obesity and associated disease, for example hyperglycemia. FIG.  1  shows the anti-obesity effect of hCNTF and leptin on body weight (left panels) and on food intake (right panels) in genetically obese mice and in mice with diet-induced obesity (DIO).

CROSS REFERENCE TO RELATED APPLICATION

The present application is the national stage under 35 U.S.C. 371 of PCT/IT97/00283, filed Nov. 18, 1997.

DESCRIPTION

The subject of the present invention is the use of molecules that activate the CNTF (ciliary neurotrophic factor) receptor—such as hCNTF (human CNTF) or mutants of hCNTF—as active principles in the formulation of pharmaceutical compositions suitable for the treatment of obesity and of related diseases. The term hCNTF mutant is intended to mean an amino acid sequence that can in theory be derived from hCNTF by substitution of one or more amino acids.

Obesity, which affects >30% of the adult population in the industrial world, is a major public health problem, since it is associated with type II diabetes, hypertension, hyperlipidemia and increased mortality rate. Obesity is the result of a positive energy balance, as a consequence of an increased ratio of caloric intake to energy expenditure. Treatment is generally unsuccessful due to the operation of mechanisms that restore adipose mass after both intentional or unintentional changes (1). The lipostasis theory postulates that the size of the body fat depot is regulated by a feedback loop, constituted by adipocyte-derived circulating molecules that act on the hypothalamus to decrease appetite and increase energy expenditure (2).

The recently identified 16-kilodalton plasma protein leptin (3) fulfills many of the criteria expected from such a lipostatic hormone. It is expressed in adipose tissue, and its plasma levels are highly correlated with body mass index in rodents and humans (4). The absence of leptin in obese (ob/ob) mutant mice leads to a massive increase in body fat, which can be reversed by systemic administration of the recombinant protein (5, 6, 7). However, human obesity does not appear to be due to deficient expression of leptin, since leptin mRNA and plasma protein levels were shown to be increased in obese versus lean subjects (4). Thus, obese humans may be insensitive to the lipostatic effect of leptin, possibly due to a defect at the level of leptin transport, leptin receptor activity, or post-receptorial signalling mechanisms (8).

There is thus a need in this specific field for new pharmacological agents capable of correcting obesity in people who are resistant to leptin.

Leptin resistance is a characteristic feature of the diabetic (db/db) mouse mutant, which expresses a truncated form of the leptin receptor lacking most of the intracytoplasmic domain (9). An animal model that more closely resembles human obesity is that of mice rendered obese by feeding a high-fat diet (DIO mice). Similar to human obese subjects, DIO mice have elevated plasma levels of leptin (4), suggesting that they are relatively insensitive to the weight-reducing effects of the hormone.

The present invention provides biologically active anti-obesity agents that can reverse obesity, as well as hyperglycemia and hyperinsulinemia associated therewith.

The subject of the present invention is therefore the use of substances that activate the CNTF receptor for the preparation of drugs for treatment of obesity and related diseases. These substances can be hCNTF (human ciliary neurotrophic factor; SEQ ID NO: 1) itself or mutants thereof (see for instance SEQ ID NOS:2 to 28). Good results have been obtained using the hCNTF mutant (Ser166Asp/Gln167His) hCNTF (10), which, from position 159 to position 178, has the following amino acid sequence (shown as SEQ ID NO: 5 in the annexed sequence listing):

Leu Lys Val Leu Gln Glu Leu Asp His Trp Thr Val Arg Ser Ile His Asp Leu Arg Phe [for sake of simplicity, this hCNTF mutant will be referred to hereinafter also as DH-CNTF]. For sake of simplicity, in the annexed sequence listing, it has been indicated only the portion from position 159 to position 178 of the mutants SEQ ID NOS: 2 to 22.

A further subject of the invention is the use of DNA coding for hCNTF or mutants thereof for the preparation of compositions for the treatment of obesity and diseases related thereto.

The present invention also has as its subject a drug for the treatment of obesity and the reduction of body weight, containing, as at least one of its active principles, hCNTF or a mutant thereof, and comprising a pharmaceutically acceptable vehicle. A pharmaceutically acceptable vehicle is intended to be a vehicle that is not dangerous for the patient, that does not degrade or deactivate the active principles or that does not interfere with the effects thereof. The preferred vehicle is a physiological saline solution, but other pharmaceutically acceptable vehicles can be used, and will easily be identified by those skilled in the art. In an embodiment that has shown good results hCNTF or mutants thereof can be used in combination with leptin: in this case the ratio wild type or mutant CNTF/leptin can be selected in the range 1:500 to 1:5, preferably 1:100 to 1:25.

hCNTF or hCNTF variants can be administered to patients in need of treatment in doses ranging from about 1 to 10,000 μg/kg body weight. A preferred dose is between 10 and 1000 μ/kg body weight. A typical daily dose for an adult is between 1 and 100 mg. The necessary amount of active principle according to the invention can be administered in a single daily dose or in multiple doses throughout the day. The treatment regime can require administration for prolonged periods. The size of the dose administered must be determined by a physician and will depend on a number of factors, such as the nature and gravity of the disease, the age and state of health of the patient and the patient's tolerance to the drug itself.

In a specific embodiment, hCNTF or a mutant thereof can be used for treatment of obese patients by means of a short-term (1-2 weeks) daily administration, in order to obtain a rapid, significant decrease in body weight (5-10%), which can be maintained subsequently using an appropriate diet and/or physical exercise.

The active protein molecules can be formulated for parenteral, nasal, bronchial or transdermal administration. The pharmaceutical composition according to the present invention is preferably administered parenterally by means of an injection. In the preferred embodiment, parenteral administration is subcutaneous or intramuscular. Other effective methods of administration are intravenous injections, slow-release parenteral formulations, inhalant mists, or suppositories. In the slow-release formulation the primary solvent can be either of an aqueous or of a non-aqueous type. Furthermore, the vehicle can contain other pharmacologically acceptable excipients to maintain or modify the pH, viscosity, clarity, colour, sterility, stability, speed of dissolution or odor of the formulation. Similarly, the vehicle can also contain other pharmacologically acceptable excipients to modify or maintain the stability, speed of dissolution, release, or absorption of the active principle. These excipients are substances that are normally used to formulate doses for parenteral administration, both in the form of single doses and in the form of multiple doses.

As mentioned above, the preferred parenteral form of administration of the formulation according to the invention is subcutaneous or intramuscular. The most preferred form of parenteral administration is subcutaneous. To obtain the required daily dose of active principle, it is possible to resort to single or repeated subcutaneous or intramuscular injections. In a preferred embodiment of the invention, the dose of active principle is between 10 and 1000 μg/kg/day. For the treatment of obesity, it may be desirable to administer the active principle periodically. Periodic administration may take the form of monthly, bi-weekly, weekly, daily or hourly administration. The required frequency of administration will be apparent to those treating the patient on the basis of standard observational techniques.

It is also possible to consider oral administration of the pharmaceutical formulations according to the invention. In this case, the active principle administered is preferably encapsulated. The encapsulated active principle can be formulated with or without the vehicles usually employed in the preparation of solid doses. Preferably, the capsule is made in such a way that the active portion of the formulation is released in the gastro-intestinal tract when bioavailability is maximized and pre-systemic degradation is minimized. The formulation can also include further excipients with the aim of facilitating absorption of the active principle. It is also possible to use diluting agents, flavouring, low melting-point waxes, vegetable oils, lubricants, suspending agents, capsule disintegration agents and binding agents.

Independently of the method of administration, the specific dose is calculated according to the approximate body weight of the patient. Further refinement of the calculations necessary to determine the appropriate dose for treatment is routinely made by those of ordinary skill in the art, who are capable of reaching these results without the need for undue experimentation, especially in the light of the tests and dosing information provided herein.

According to the present invention, an obese patient is administered a therapeutically effective amount of active principle. As mentioned above, the dose required can be determined by those skilled in the art without the need for undue experimentation. A “therapeutically effective amount” can be defined as the amount of active principle that is sufficient to cause an adequate loss of weight and to result in the consequent normalisation of metabolic parameters, such as the blood glucose level of the obese patient.

Up to this point a general description has been given of the present invention. With the aid of the following examples, a more detailed description will now be provided, with reference to specific embodiments, aimed at giving a better understanding of the aims, characteristics, advantages and operating methods of the invention. However, the scope of the present invention is not intended to be limited thereby.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1

Effects of hCNTF and leptin on body weight (left panels) and food intake (right panels) in genetically obese mice (ob/ob and db/db) and mice with diet-induced obesity (DIO). Mice received daily intraperitoneal injections of either vehicle or proteins (amounts in μg/mouse), starting at day 0. Body weight is expressed as percent of the original weight on day −2 and represents the average±s.e.m (n=3 for ob/ob and db/db, n=5 for DIO mice). Baseline weights for each group of vehicle-treated animals were (in grams): ob/ob, 49.3±0.3; db/db, 39.1±2.5; DIO, 42.6±0.8. Statistical significance was determined by repeated measures ANOVA. For all groups, P-values for the effects of treatment, time, and time x treatment were: P<0.05, P<0.0001 and P<0.01, respectively.

FIG. 2

Effects of hCNTF (2 μ/mouse) and leptin (100 μg/mouse), administered alone or in combination, on weight loss in DIO mice. Mice received daily intraperitoneal injections of the indicated agents.

FIG. 3

Duration of DH-CNTF effects on body weight and food intake in obese vs. lean mice. C57BL/KS db/db mice (circles), or age-and sex-matched C57BL/KS +/+ mice (squares), housed in groups of five, received daily intraperitoneal injections of either vehicle (empty symbols) or 10 μg of DH-CNTF (filled symbols) for 25 days. From day 26, all mice were treated with vehicle. Food intake is the number of grams consumed per group divided by five.

FIG. 4

Effects of DH-CNTF treatment of obese mice on carcass composition. Mice were treated for 10 days by daily intraperitoneal injections of either vehicle or 10 μg of DH-CNTF. Results are the mean ± s.e.m. (n=5). *P<0.05; **P<0.01 vs. vehicle by Student's t-test.

FIG. 5

Effects of leptin and hCNTF on STAT factor activation in neuronal cell lines. GT-1-7 and SN-56 cells transfected with an expression vector for human OB-Rb were incubated for 10 min in the presence or absence of the indicated cytokines (at 100 ng/ml). Activation of cellular STAT factors was determined by electromobility shift assay. Arrows denote the positions of migration of bound STAT3 homodimers, STAT1:STAT3 heterodimers, and STAT1 homodimers.

FIG. 6

Expression of receptor subunits for leptin (OB-Rb) and CNTF (CNTF receptor-α [CNTFRα] and LIFR) in mouse hypothalamus, as determined by in situ hybridisation. A, arcuate nucleus; P, paraventricular nucleus. (X100)

FIG. 7

Effects of leptin and hCNTF on tis-11 expression in mouse hypothalamus. Groups of three ob/ob mice received intraperitoneal injections of either vehicle, leptin (100 μg) or DH-hCNTF (10 μg) and were sacrificed one hour later by cervical dislocation. In situ hybridization was performed on frozen coronal brain sections from vehicle- or protein-treated mice, using ³⁵S-labelled cRNA probes specific for murine tis-11. (x 100).

EXAMPLE 1

Anti-obesity Effects of hCNTF and its Mutant DH-CNTF Methods

Protein Production

Recombinant human CNTF and DH-CNTF were produced in E. coli BL21 as previously described (11). The DNA coding sequence for human leptin was assembled by PCR using synthetic oligodeoxyribonucleotides according to the method of Stemmer et al. (12), and subcloned into the bacterial expression plasmid pRSET-5d (13). Human leptin was produced using the same protocol as for hCNTF. All proteins were purified by reverse-phase HPLC (11) in order to remove bacterial lipopolysaccharide. Purified preparations contained less than 5 ng endotoxin/mg protein, as determined by the Limulus amoebocyte assay (Sigma).

Animal Studies

Experiments were performed using groups of male 10-11 week-old C57BL/6J ob/ob and C57BL/KS db/db mice, and 19 week-old AKR/J mice rendered obese by feeding a high-fat diet (14) starting at 12 weeks of age. Except where noted otherwise, animals were housed in individual cages with ad libitum access to water and either standard or high-fat (AKR mice) rodent chow, under a 12 hour light-dark cycle (lights on at 7:30 hr, off at 19:30 hr). They were accustomed to daily (9:00 hr) intraperitoneal injections of vehicle (0.9% saline, 0.2 mg/ml endotoxin-free bovine serum albumin) for two days before the beginning of the treatment (day 0) with either vehicle or cytokines. Animals were weighed after injection and food intake was determined by recording the amount of chow remaining in food dishes.

Results

Human ciliary neurotrophic factor (hCNTF), its mutant DH-CNTF (10) [(Ser166Asp/Gln167His) hCNTF]; a mutant of hCNTF with 40-fold higher affinity for the CNTF a-receptor) and human leptin were tested for biological activity in genetically obese mice, and in mice with diet-induced obesity (DIO). These models of obesity and diabetes are generally accepted in the art as indicative of the obese condition. Agents showing an anti-obesity effect in these models will show a similar effect in other mammals, in particular in man.

As will be seen more clearly in the following, the compounds of the invention are active in all the biological tests mentioned above, and are also found to be anti-obesity agents. Furthermore, they are active in reversing the hyperglycemia and hyperinsulinemia associated with obesity. It is therefore assumed that these compounds will also be of use in the treatment of hyperglycemia in human diabetes mellitus.

In accordance with previous experiments and results (6-8, 15), it was found that systematic administration of leptin to mutant mice, which do not express functional leptin, reverses the obesity and the hyperphagia associated with leptin deficiency. Daily intraperitoneal administration of hCNTF (between 2 and 50 μg/mouse; corresponding to 40-1000 μg/kg body weight) to ob/ob mice also produces a progressive and dose-dependent decrease in body weight, as well as a rapid reduction in food intake (FIG. 1). At the highest dose tested (50 μg; 1000 μg/kg), hCNTF causes a 16% decrease in body weight after 7 days (compared with a 5% increase in vehicle-treated controls), and a 5-fold decrease in food intake. These effects are comparable in magnitude to those of a 100 μg (2000 μg/kg) dose of leptin (13% and 95% reductions in body weight and food intake, respectively; P<0.0001 by Student's t-test). The hCNTF variant DH-CNTF produces similar reductions in body weight and food intake at doses approximately 5 times lower than those of hCNTF. This result, together with the lack of activity of hCNTF variants (11) with impaired receptor interaction (data not shown), suggests that the anti-obesity effect of hCNTF is mediated through activation of specific CNTF receptors.

The db/db mutant mouse does not respond to leptin (6-8, 15), because of a mutation in the gene coding for the leptin receptor OB-R, which results in the production of a receptor splice variant with a truncated intracytoplasmic domain (9, 29). In contrast, treatment of db/db mice with hCNTF causes a dose- and time-dependent weight loss and suppression of food intake (FIG. 1). The superagonist DH-CNTF elicited comparable effects at approximately ⅕ the dose of hCNTF. The results obtained in ob/ob and db/db mice show that hCNTF does not act by stimulating the release of leptin or by direct activation of leptin receptors.

AKR mice rendered obese by feeding a high-fat diet (DIO mice) have been previously reported to be less sensitive than ob/ob mice to the weight- and appetite-reducing effects of leptin (7). This finding, together with the observation that plasma levels of leptin are higher in DIO mice than in lean littermates, led to the proposal that diet-induced obesity is associated with leptin resistance (4, 17). As shown in FIG. 1, a 5-day treatment of DIO mice with human leptin (100 μg; 2500 μg/kg) causes modest decreases in body weight (7±1% ; p<0.05 vs. vehicle) and food intake (27±2%; P<0.05). In contrast, hCNTF (50 μg; 1250 μg/kg) and DH-CNTF (10 μg; 250 μg/kg) elicit more extensive reductions in body weight (19±1% and 24±1%, respectively; P<0.0001) and food intake (76±4%, and 73±7%, respectively; P<0.0005). The discovery that hCNTF can reverse obesity in both db/db and DIO mice has important implications for the treatment of human obesity, which has been postulated to be associated with resistance to leptin (4, 18, 19).

As can be seen, the obese mice received daily intraperitoneal administrations of hCNTF or of the mutant DH-CNTF in doses of from 2 to 50 μg. corresponding to 50-1000 μg/kg body weight. At the highest dose, the compounds cause a reduction of over 10% in the body weight after 5 days of treatment. Therefore, doses of hCNTF or DH-CNTF of under 1000 μg/kg are administered to patients suffering from obesity, preferably doses of approximately 100 μg/kg, in order to induce a rapid reduction in body weight (5-10%). Furthermore, in this form of preferred embodiment, hCNTF or DH-CNTF is administered once a day and the treatment is continued for a few days, until the required reduction in body weight is obtained.

EXAMPLE 2

Increase in the Anti-obesity Effect of Leptin Due to Synergism With hCNTF in DIO Mice

Obese DIO mice were given daily intraperitoneal injections of leptin (100 μg; corresponding to 2500 μg/kg) along with a small dose (2 μg, corresponding to 50 μg/kg) of hCNTF. Neither of the two agents produces a significant weight loss per se. This treatment has the effect of producing a strong, synergistic loss of body weight (FIG. 2). This result proves that small doses of hCNTF can be used to give a significant increase in the effect of leptin in a model of obesity associated with a resistance to leptin.

EXAMPLE 3

Duration and Specificity of the Anti-obesity Effects of DH-CNTF

Methods

Behavioral Studies

Locomotor activity was measured by scoring the number of times mice crossed the middle of their home cages during three hours of the dark cycle (21:00 hr-24:00 hr). Grooming behavior was assessed by focal observations in home cages (five observations of 1 min each during 30 min of the light cycle), using a rating scale from 0 to 3 (0, no activity; 1, weak; 2, normal; 3 hyperactive). Conditioned taste aversion was performed using a two-bottle paradigm with 0.1% saccharin as a novel taste (20).

Body Composition

Carcasses were homogenized, and 2-gram aliquots were lyophilized and then oven-dried at 90° until weight was constant. Fat was then extracted with ethyl ether/ethanol (20:1, v/v) (21). Water and fat mass were calculated from the weight differences after dehydration and fat extraction, respectively. Lean mass was defined as the remaining amount of carcass.

Results

hCNTF has previously been reported to cause a transient reduction of body weight and food intake in normal mice (22) Its effects on obese animals have not been studied heretofore. It is therefore important to determine whether or not its effects on obese mice are subject to desensitisation. As shown in FIG. 3, DH-hCNTF produces protracted effects in obese mice. A 25-day treatment of db/db mice with DH-CNTF leads to a progressive and steady decrease in body weight, which by day 8 reaches a level corresponding to that of age- and sex-matched wild-type mice. In parallel, DH-CNTF elicits a ˜50% decrease in food intake, which persists throughout the treatment. Similar results were obtained in ob/ob mice treated for 17 days with hCNTF (data not shown). In contrast, DH-CNTF elicits only transient effects in strain-matched wild-type mice. Thus, DH-CNTF rapidly depresses both food intake and the rate of body weight change in lean mice, but these effects subside after approximately 5 and 10 days of treatment, respectively (FIG. 3).

A possible explanation for the observed differences between obese and lean animals is that hCNTF, similarly to leptin (5,6), predominantly depletes adipose tissue mass, such that the extent and duration of its effect would depend on the size of fat depots. Indeed, DH-CNTF specifically reduces the percentage of body fat in ob/ob and db/db mice, while increasing that of body water and lean mass as compared with vehicle-treated controls (FIG. 4). The absolute weight loss induced by DH-CNTF can be accounted for by a predominant loss of body fat (60-70% of lost mass), accompanied by a smaller reduction in water mass (see absolute weights in FIG. 4). Leptin produces similar effects in ob/ob mice (5,6). Thus, in obese mice, hCNTF elicits specific anti-adiposity effects. In contrast, hCNTF has been reported to cause reductions in muscle (23) or protein (24) mass in lean animals. A plausible explanation for this apparent discrepancy is that the predominant fat-depleting effect of hCNTF leads to a nearly total loss of body fat in lean animals (ref. (23) and our unpublished results), which causes protein loss as a secondary event.

hCNTF does not induce toxicity, malaise or illness. Irreversible toxicity was ruled out by the finding that body weight and food intake rapidly return to pretreatment levels following interruption of protein administration, both in db/db (FIGS. 2G, H) and ob/ob mice (data not shown). Locomotor activity is not significantly altered by a 3-day treatment of db/db mice with DH-CNTF (10 μg) as compared to vehicle-treated controls (activity scores: 43±6 and 49±6, respectively; n=5). Likewise, DH-CNTF treatment does not alter grooming behavior (activity scores: 1.2±0.6 and 1.0±0.4, for DH-CNTF and vehicle-treated, respectively). In addition, DH-CNTF does not induce any form of stereotypic behavior. The possibility that the protein causes taste aversion was examined in DIO mice using a two-bottle paradigm with 0.1% saccharin as a novel taste (20). Similarly to leptin, which was reported to reduce water intake in ob/ob mice (5), DH-CNTF (10 μg) causes a decrease in water intake of DIO mice 2 days after conditioning (1.8±0.1 ml vs. 2.8±0.2 ml in vehicle-treated controls; n=9; P<0.001). However, DH-CNTF does not cause taste aversion (saccharin intake 49±2% of total fluid vs. 51±4% in controls). These results indicate that the satiety effect of DH-CNTF is not due to cytokine-induced sickness behavior.

EXAMPLE 4

Reversal of Obesity-associated Metabolic Defects By hCNTF and DH-CNTF

Methods

Mice received daily intraperitoneal injections of either vehicle, leptin (100 μg), hCNTF (50 pg) or DH-CNTF (10 μg). In pair-feeding experiments (2 and 4), vehicle-treated mice were either fed ad libitum (control) or fed the same amount of chow consumed by DH-CNTF-treated mice during the preceding 24-hour period. Blood samples were taken 24 hours after the last injection (experiments 1 and 3), or 7 hours after the last injection and the removal of food (experiments 2 and 4). Serum glucose was determined by the glucose oxidase method and serum insulin by radioimmunoassay (Amersham), using rat insulin as standard.

Results

In addition to its weight- and appetite-regulating actions, hCNTF and DH-CNTF are able to reverse the hyperglycemia and hyperinsulinemia associated with the ob and db mutations.

Mice bearing the ob mutation on the C57BL/6 background exhibit strong hyperinsulinemia (with nearly normal glucose levels after the age of 2-3 months) (25), which can be corrected by leptin treatment (5,6,15). Treatment of ob/ob mice with hCNTF or DH-CNTF also lead to strong reductions in serum insulin levels (Table 1, experiments 1 and 2). The db/db mutant on the C57BL/KS background is characterized by severe hyperglycemia (with nearly normal insulin levels after the age of 2-3 months) (26). As previously reported (5,6,15), leptin is unable to reverse hyperglycemia in db/db mice. In contrast, hCNTF and DH-hCNTF lead to 2-3-fold reductions in both fed and fasted serum glucose levels, without affecting the already low levels of insulin (Table 1, experiments 3 and 4). The weight-reducing and anti-diabetic effects of DH-CNTF exceed those induced by pair-feeding of ob/ob or db/db mice to the food intake of cytokine-treated animals (Table 1, experiments 2 and 4). These results show that the effects of hCNTF, similarly to those of leptin (6, 27, 28) are not solely due to decreased food intake.

TABLE 1 Effects of leptin, hCNTF and pair-feeding on body weight change and serum insulin and glucose in obese mice Weight change Serum glucose Serum insulin Treatment (g) (mM) (ng/ml) Experiment 1 (ob/ob, 7 days) Vehicle +1.6 ± 0.1  nd 63.3 ± 12.7 Leptin −6.5 ± 0.4** nd 8.1 ± 9.1* hCNTF −8.2 ± 0.1** nd 4.3 ± 1.0* DH-CNTF −7.7 ± 0.8** nd 3.2 ± 2.9* Experiment 2 (ob/ob, 4 days) Vehicle +0.5 ± 0.5  nd 72.5 ± 25.7 DH-CNTF  −8.4 ± 0.5**§ nd 8.1 ± 0.2*↑ Pair-fed −7.0 ± 0.5** nd 11.1 ± 0.4* Experiment 3 (db/db, 7 days) Vehicle +0.2 ± 0.4  23.3 ± 0.8  9.1 ± 4.2 Leptin −0.8 ± 0.5  28.7 ± 0.8* 9.7 ± 2.6 hCNTF −6.8 ± 0.5**  8.4 ± 1.7** 8.2 ± 2.1 Experiment 4 (db/db, 4 days) Vehicle 0.0 ± 0.3  30.1 ± 2.0 nd DH-CNTF  −6.8 ± 0.4**§ 12.3 ± 1.9**§ nd Pair-fed −5.3 ± 0.4** 24.8 ± 5.4 nd Data are mean values ± s.e.m. from 3-6 animals per treatment group. nd, not determined. *P < 0.05 vs. vehicle **P < 0.001 vs. vehicle §P < 0.05 vs. pair-fed ↑P < 0.001 vs. pair-fed (Student's t-test).

EXAMPLE 5

hCNTF and Leptin Activate Overlapping neuronal Signaling Systems

Methods

STAT Activation Assay

GT-1-7 and SN-56 cells were maintained in complete culture medium (Dulbecco's modified Eagle medium containing 10% fetal calf serum, penicillin, glutamine and, for SN-56 cells, sodium pyruvate). Cells were plated in 100 mm dishes and used 24 hours later, when semi-confluent. An expression vector containing the entire coding region (nucleotides 141-3770) of human OB-R (29) was prepared as previously described (30) and was transfected into the cells by Lipofectamine (Gibco BRL) according to the manufacturer's instructions. After 24 hours, cells were distributed into 60 mm culture dishes containing complete culture medium, and after an additional 24 hours, they were deprived of serum for 4 hours before a 10 min treatment with different effectors, as specified below. The cells were then washed with ice-cold phosphate-buffered saline containing 50 mM NaF, collected by centrifugation and frozen in liquid nitrogen. Total cell extracts were prepared as previously described (31). Binding of activated STAT factors to the high affinity SIE m67 oligonucleotide (32) was determined by electromobility shift assays according to Sadowsky and Gilman (33), using 10 μg of cell extract. The oligonucleotide probe was labelled by filling in 5′ protruding ends with Klenow enzyme in the presence of [a-³²P]DATP and [a-³²P]dCTP (3000 Ci/mmol). Complexes were resolved on 5% polyacrylamide/2.5% glycerol/0.5×TBE (45 mM Tris-borate, 0.5 mM EDTA, pH 7.8) gels, which were then dried and subjected to autoradiography.

In Situ Hybridization

Serial coronal brain sections were prepared in the region containing the arcuate and paraventricular hypothalamic nuclei. In situ hybridization was performed according to previously described procedures (34), using ³⁵S-labelled CRNA probes. Specific probes for murine OB-Rb, CNTFRa, LIFR and tis-11 were obtained by RT-PCR amplification of mouse brain RNA using appropriate oligonucleotide primers, and corresponded to nucleotides 2850-3407, 246-856 (numbering according to the human sequence) 2620-3217, and 1-950 of the respective coding sequences.

Results

The partially shared biological activities of hCNTF and leptin suggest that these proteins act through similar signaling mechanisms. The ability of hCNTF and leptin to regulate the DNA binding activity of STAT transcription factors was examined in two neuronal cell lines, SN-56 (35) and GT-1-7 (36), derived from mouse septal and hypothalamic neurons, respectively. Cells were transfected with an expression vector for human OB-Rb, the signaling-competent long-form splice variant of OB-R (30, 37, 38). In both neuronal cell lines, hCNTF and leptin trigger the activation of a similar pattern of STAT factors, with predominant DNA binding of STAT3 homodimers and, to a lesser degree, that of STAT1 homodimers and STAT1/STAT3 heterodimers. (FIG. 5). This pattern is characteristic of gp130-signaling cytokines (39), consistent with the sequence similarity, including the presence of consensus motifs for JAK kinase and STAT factor interaction sites, between OB-Rb and receptors of the gp130 family (9).

A possible explanation for the overlapping metabolic effects of leptin and hCNTF is that these proteins stimulate common effector pathways in brain areas involved in the regulation of energy intake and expenditure. The long-form OB-Rb splice variant, is predominantly expressed in such regions, including the arcuate, ventromedial and paraventricular hypothalamic nuclei (40,41). To determine whether hypothalamic satiety centers could also be targets for hCNTF, in situ hybridization was performed using cRNA probes specific for murine OB-Rb, CNTFRα and LIFR. As shown in FIG. 6, the arcuate and paraventricular nuclei of the mouse hypothalamus express mRNAs for leptin and CNTF receptor subunits. Preliminary results indicate expression of CNTFRα and LIFR in additional nuclei, including the ventromedial hypothalamus.

In agreement with the existence of a cytokine signaling pathway to central satiety centers, systemically administered leptin activates early signaling responses in mouse hypothalamus (42, 43). If the mechanism of action of hCNTF is similar to that of leptin, early activation of hypothalamic responses should be detectable also after peripheral administration of hCNTF. The tis-11 primary response gene (44), which is rapidly induced by hCNTF and other Stat3-dependent cytokines (45) was used as a marker for cellular activation. Hypothalamic tis-11 MRNA of ob/ob mice was found to be significantly elevated one hour after intraperitoneal injection of leptin or DH-CNTF as compared to vehicle-treated controls. In situ hybridization revealed that the arcuate nucleus is a major site of tis-11 induction by both cytokines (FIG. 7).

This result demonstrates that systemically administered hCNTF and leptin can induce early signaling responses in a brain region that has been implicated as an important target of leptin action (15, 41). It cannot be excluded that the cytokines activate hypothalamic cells indirectly, for instance through peripheral mediators or via afferent nerves. Yet, the rapidity of this effect, together with the expression of specific receptors for hCNTF and leptin in the arcuate nucleus argue for a direct action consequent to cytokine entry into the hypothalamus. Both hCNTF (46) and leptin (47) can cross the blood-brain barrier. Cytokines may penetrate into the brain via specific transport systems, as reported for leptin (47). They may also gain access to hypothalamic neurons through circumventricular organs lying outside the blood-brain barrier, such as the median eminence, which is adjacent to the arcuate nucleus (48). In conclusion, the present results are consistent with the notion that the partially shared biological activities of hCNTF and leptin involve a related mechanism of action.

EXAMPLE 6

CNTFRα Binding Activities of hCNTF and hCNTF Variants

The relative binding affinities to CNTF receptor-α (CNTFRα) of hCNTF and different hCNTF variants were determined by solid phase binding assay as previously described (10). As shown in Table 2, a number of hCNTF variants possessed greater affinity for CNTFRa than wild-type hCNTF. These variants, like DH-CNTF, have increased utility for treatment of obesity and associated diseases, such as diabetes.

TABLE 2 CNTF receptor α binding of hCNTF and hCNTF variants SEQ Relative ID Abbrevn./ Binding NO: Name note (hCNTF = 1)  1 hCNTF wild type 1.1 ± 0.3  2 (Gln167Thr) hCNTF 11.8 ± 0.3   3 (Lys160Gln/Gln167Thr) hCNTF 3.1 ± 1.0  4 (Gln167Tyr) hCNTF 9.6 ± 2.6  5 (Ser166Asp/Gln167His) hCNTF DH-CNTF 22.8 ± 3.5   6 (Gln163Ser/Gln167His) hCNTF 4.1 ± 1.1  7 (Gln167Ala) hCNTF 9.0 ± 0.7  8 (Ser166Ala/Gln167Ala) hCNTF 8.1 ± 2.8  9 (Ser166Gly/Gln167Ala) hCNTF 7.5 ± 2.2 10 (Ser166Asn/Gln167Ala) hCNTF 12.4 ± 1.2  11 (Ser166His/Gln167Ala) hCNTF 8.8 ± 2.6 12 (Ser166Asp/Gln167Ala) hCNTF 13.5 ± 1.7  13 (Val161Leu/Gln167Ala) hCNTF 8.8 ± 0.4 14 (Lys160Gln/Gln167Ala) hCNTF 11.7 ± 3.2  15 (Gln167Ala/His174Ala) hCNTF 3.6 ± 0.8 16 (Gln167Ala/Arg177Leu) hCNTF 11.7 ± 3.3  17 (Gln167Ala/Thr169Ser) hCNTF 6.9 ± 1.3 18 (Gln167Ala/Thr169Leu) hCNTF 9.6 ± 2.2 19 (Gln167Ala/Thr169Leu/Phe178Ile) hC 8.4 ± 0.4 20 (Ser166Asp/Gln167Ala/Thr169Leu) hC 21.0 ± 1.6  21 (Ser166Asp/Gln167Ala/Arg177Phe) hC 13.1 ± 2.0  22 (Val170Arg/His174Ala) hCNTF 3.3 ± 0.4 23 (Phe152Ala/Ser166Asp/Gln167His) hC 32 ± 11 24 (Lys155Ala/Ser166Asp/Gln167His) hC 51 ± 19 25 (Gln63Arg) hCNTF 2.0 ± 0.3 26 (Gln63Arg/Ser166Asp/Gln167His) hCN 66 ± 16 27 (Asp30Gln/Ser166Asp/Gln167His) hCN 30 ± 5  28 (Thr169Ile/His174Ala) hCNTP 0.07 ± 0.01

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28 1 200 PRT Human 1 Met Ala Phe Thr Glu His Ser Pro Leu Thr Pro His Arg Arg Asp Leu 1 5 10 15 Cys Ser Arg Ser Ile Trp Leu Ala Arg Lys Ile Arg Ser Asp Leu Thr 20 25 30 Ala Leu Thr Glu Ser Tyr Val Lys His Gln Gly Leu Asn Lys Asn Ile 35 40 45 Asn Leu Asp Ser Ala Asp Gly Met Pro Val Ala Ser Thr Asp Gln Trp 50 55 60 Ser Glu Leu Thr Glu Ala Glu Arg Leu Gln Glu Asn Leu Gln Ala Tyr 65 70 75 80 Arg Thr Phe His Val Leu Leu Ala Arg Leu Leu Glu Asp Gln Gln Val 85 90 95 His Phe Thr Pro Thr Glu Gly Asp Phe His Gln Ala Ile His Thr Leu 100 105 110 Leu Leu Gln Val Ala Ala Phe Ala Tyr Gln Ile Glu Glu Leu Met Ile 115 120 125 Leu Leu Glu Tyr Lys Ile Pro Arg Asn Glu Ala Asp Gly Met Pro Ile 130 135 140 Asn Val Gly Asp Gly Gly Leu Phe Glu Lys Lys Leu Trp Gly Leu Lys 145 150 155 160 Val Leu Gln Glu Leu Ser Gln Trp Thr Val Arg Ser Ile His Asp Leu 165 170 175 Arg Phe Ile Ser Ser His Gln Thr Gly Ile Pro Ala Arg Gly Ser His 180 185 190 Tyr Ile Ala Asn Asn Lys Lys Met 195 200 2 20 PRT Artificial Sequence (Gln167Thr) hCNTF sequence from position 159 to position 178 2 Leu Lys Val Leu Gln Glu Leu Ser Thr Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 3 20 PRT Artificial Sequence (Lys160Gln/Gln167Thr) hCNTF sequence from position 159 to position 178 3 Leu Gln Val Leu Gln Glu Leu Ser Thr Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 4 20 PRT Artificial Sequence (Gln167Tyr) hCNTF sequence from position 159 to position 178 4 Leu Lys Val Leu Gln Glu Leu Ser Tyr Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 5 20 PRT Artificial Sequence (Ser166Asp/Gln167His) hCNTF sequence from position 159 to position 178 5 Leu Lys Val Leu Gln Glu Leu Asp His Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 6 20 PRT Artificial Sequence (Gln163Ser/Gln167His) hCNTF sequence from position 159 to position 178 6 Leu Lys Val Leu Ser Glu Leu Ser His Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 7 20 PRT Artificial Sequence (Gln167Ala) hCNTF sequence from position 159 to position 178 7 Leu Lys Val Leu Gln Glu Leu Ser Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 8 20 PRT Artificial Sequence (Ser166Ala/Gln167Ala) hCNTF sequence from position 159 to position 178 8 Leu Lys Val Leu Gln Glu Leu Ala Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 9 20 PRT Artificial Sequence (Ser166Gly/Gln167Ala) hCNTF sequence from position 159 to position 178 9 Leu Lys Val Leu Gln Glu Leu Gly Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 10 20 PRT Artificial Sequence (Ser166Asn/Gln167Ala) hCNTF sequence from position 159 to position 178 10 Leu Lys Val Leu Gln Glu Leu Asn Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 11 20 PRT Artificial Sequence (Ser166His/Gln167Ala) hCNTF sequence from position 159 to position 178 11 Leu Lys Val Leu Gln Glu Leu His Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 12 20 PRT Artificial Sequence (Ser166Asp/Gln167Ala) hCNTF sequence from position 159 to position 178 12 Leu Lys Val Leu Gln Glu Leu Asp Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 13 20 PRT Artificial Sequence (Val161Leu/Gln167Ala) hCNTF sequence from position 159 to position 178 13 Leu Lys Leu Leu Gln Glu Leu Ser Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 14 20 PRT Artificial Sequence (Lys160Gln/Gln167Ala) hCNTF sequence from position 159 to position 178 14 Leu Gln Val Leu Gln Glu Leu Ser Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 15 20 PRT Artificial Sequence (Gln167Ala/His174Ala) hCNTF sequence from position 159 to position 178 15 Leu Lys Val Leu Gln Glu Leu Ser Ala Trp Thr Val Arg Ser Ile Ala 1 5 10 15 Asp Leu Arg Phe 20 16 20 PRT Artificial Sequence (Gln167Ala/Arg177Leu) hCNTF sequence from position 159 to position 178 16 Leu Lys Val Leu Gln Glu Leu Ser Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Leu Phe 20 17 20 PRT Artificial Sequence (Gln167Ala/Thr169Ser) hCNTF sequence from position 159 to position 178 17 Leu Lys Val Leu Gln Glu Leu Ser Ala Trp Ser Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 18 20 PRT Artificial Sequence (Gln167Ala/Thr169Leu) hCNTF sequence from position 159 to position 178 18 Leu Lys Val Leu Gln Glu Leu Ser Ala Trp Leu Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 19 20 PRT Artificial Sequence (Gln167Ala/Thr169Leu/Phe178Ile) hCNTF sequence from position 159 to position 178 19 Leu Lys Val Leu Gln Glu Leu Ser Ala Trp Leu Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Ile 20 20 20 PRT Artificial Sequence (Ser166Asp/Gln167Ala/Thr169Leu) hCNTF sequence from position 159 to position 178 20 Leu Lys Val Leu Gln Glu Leu Asp Ala Trp Leu Val Arg Ser Ile His 1 5 10 15 Asp Leu Arg Phe 20 21 20 PRT Artificial Sequence (Ser166Asp/Gln167Ala/Arg177Phe) hCNTF sequence from position 159 to position 178 21 Leu Lys Val Leu Gln Glu Leu Asp Ala Trp Thr Val Arg Ser Ile His 1 5 10 15 Asp Leu Phe Phe 20 22 20 PRT Artificial Sequence (Val170Arg/His174Ala) hCNTF sequence from position 159 to position 178 22 Leu Lys Val Leu Gln Glu Leu Ser Gln Trp Thr Arg Arg Ser Ile Ala 1 5 10 15 Asp Leu Arg Phe 20 23 200 PRT Artificial Sequence (Phe152Ala/Ser166Asp/Gln167His) hCNTF sequence from position 1 to position 200 23 Met Ala Phe Thr Glu His Ser Pro Leu Thr Pro His Arg Arg Asp Leu 1 5 10 15 Cys Ser Arg Ser Ile Trp Leu Ala Arg Lys Ile Arg Ser Asp Leu Thr 20 25 30 Ala Leu Thr Glu Ser Tyr Val Lys His Gln Gly Leu Asn Lys Asn Ile 35 40 45 Asn Leu Asp Ser Ala Asp Gly Met Pro Val Ala Ser Thr Asp Gln Trp 50 55 60 Ser Glu Leu Thr Glu Ala Glu Arg Leu Gln Glu Asn Leu Gln Ala Tyr 65 70 75 80 Arg Thr Phe His Val Leu Leu Ala Arg Leu Leu Glu Asp Gln Gln Val 85 90 95 His Phe Thr Pro Thr Glu Gly Asp Phe His Gln Ala Ile His Thr Leu 100 105 110 Leu Leu Gln Val Ala Ala Phe Ala Tyr Gln Ile Glu Glu Leu Met Ile 115 120 125 Leu Leu Glu Tyr Lys Ile Pro Arg Asn Glu Ala Asp Gly Met Pro Ile 130 135 140 Asn Val Gly Asp Gly Gly Leu Ala Glu Lys Lys Leu Trp Gly Leu Gln 145 150 155 160 Val Leu Gln Glu Leu Asp His Trp Thr Val Arg Ser Ile His Asp Leu 165 170 175 Arg Phe Ile Ser Ser His Thr Thr Gly Ile Pro Ala Arg Gly Ser His 180 185 190 Tyr Ile Ala Asn Asn Lys Lys Met 195 200 24 200 PRT Artificial Sequence (Lys155Ala/Ser166Asp/Gln167His) hCNTF sequence from position 1 to position 200 24 Met Ala Phe Thr Glu His Ser Pro Leu Thr Pro His Arg Arg Asp Leu 1 5 10 15 Cys Ser Arg Ser Ile Trp Leu Ala Arg Lys Ile Arg Ser Asp Leu Thr 20 25 30 Ala Leu Thr Glu Ser Tyr Val Lys His Gln Gly Leu Asn Lys Asn Ile 35 40 45 Asn Leu Asp Ser Ala Asp Gly Met Pro Val Ala Ser Thr Asp Gln Trp 50 55 60 Ser Glu Leu Thr Glu Ala Glu Arg Leu Gln Glu Asn Leu Gln Ala Tyr 65 70 75 80 Arg Thr Phe His Val Leu Leu Ala Arg Leu Leu Glu Asp Gln Gln Val 85 90 95 His Phe Thr Pro Thr Glu Gly Asp Phe His Gln Ala Ile His Thr Leu 100 105 110 Leu Leu Gln Val Ala Ala Phe Ala Tyr Gln Ile Glu Glu Leu Met Ile 115 120 125 Leu Leu Glu Tyr Lys Ile Pro Arg Asn Glu Ala Asp Gly Met Pro Ile 130 135 140 Asn Val Gly Asp Gly Gly Leu Phe Glu Lys Ala Leu Trp Gly Leu Lys 145 150 155 160 Val Leu Gln Glu Leu Asp His Trp Thr Val Arg Ser Ile His Asp Leu 165 170 175 Arg Phe Ile Ser Ser His Gln Thr Gly Ile Pro Ala Arg Gly Ser His 180 185 190 Tyr Ile Ala Asn Asn Lys Lys Met 195 200 25 200 PRT Artificial Sequence (Q63R) hCNTF sequence from position 1 to position 200 25 Met Ala Phe Thr Glu His Ser Pro Leu Thr Pro His Arg Arg Asp Leu 1 5 10 15 Cys Ser Arg Ser Ile Trp Leu Ala Arg Lys Ile Arg Ser Asp Leu Thr 20 25 30 Ala Leu Thr Glu Ser Tyr Val Lys His Gln Gly Leu Asn Lys Asn Ile 35 40 45 Asn Leu Asp Ser Ala Asp Gly Met Pro Val Ala Ser Thr Asp Arg Trp 50 55 60 Ser Glu Leu Thr Glu Ala Glu Arg Leu Gln Glu Asn Leu Gln Ala Tyr 65 70 75 80 Arg Thr Phe His Val Leu Leu Ala Arg Leu Leu Glu Asp Gln Gln Val 85 90 95 His Phe Thr Pro Thr Glu Gly Asp Phe His Gln Ala Ile His Thr Leu 100 105 110 Leu Leu Gln Val Ala Ala Phe Ala Tyr Gln Ile Glu Glu Leu Met Ile 115 120 125 Leu Leu Glu Tyr Lys Ile Pro Arg Asn Glu Ala Asp Gly Met Pro Ile 130 135 140 Asn Val Gly Asp Gly Gly Leu Phe Glu Lys Lys Leu Trp Gly Leu Lys 145 150 155 160 Val Leu Gln Glu Leu Ser Gln Trp Thr Val Arg Ser Ile His Asp Leu 165 170 175 Arg Phe Ile Ser Ser His Gln Thr Gly Ile Pro Ala Arg Gly Ser His 180 185 190 Tyr Ile Ala Asn Asn Lys Lys Met 195 200 26 200 PRT Artificial Sequence (Gln63Arg/Ser166Asp/Gln167His) hCNTF sequence from positioin 1 to position 200 26 Met Ala Phe Thr Glu His Ser Pro Leu Thr Pro His Arg Arg Asp Leu 1 5 10 15 Cys Ser Arg Ser Ile Trp Leu Ala Arg Lys Ile Arg Ser Asp Leu Thr 20 25 30 Ala Leu Thr Glu Ser Tyr Val Lys His Gln Gly Leu Asn Lys Asn Ile 35 40 45 Asn Leu Asp Ser Ala Asp Gly Met Pro Val Ala Ser Thr Asp Arg Trp 50 55 60 Ser Glu Leu Thr Glu Ala Glu Arg Leu Gln Glu Asn Leu Gln Ala Tyr 65 70 75 80 Arg Thr Phe His Val Leu Leu Ala Arg Leu Leu Glu Asp Gln Gln Val 85 90 95 His Phe Thr Pro Thr Glu Gly Asp Phe His Gln Ala Ile His Thr Leu 100 105 110 Leu Leu Gln Val Ala Ala Phe Ala Tyr Gln Ile Glu Glu Leu Met Ile 115 120 125 Leu Leu Glu Tyr Lys Ile Pro Arg Asn Glu Ala Asp Gly Met Pro Ile 130 135 140 Asn Val Gly Asp Gly Gly Leu Phe Glu Lys Lys Leu Trp Gly Leu Lys 145 150 155 160 Val Leu Gln Glu Leu Asp His Trp Thr Val Arg Ser Ile His Asp Leu 165 170 175 Arg Phe Ile Ser Ser His Gln Thr Gly Ile Pro Ala Arg Gly Ser His 180 185 190 Tyr Ile Ala Asn Asn Lys Lys Met 195 200 27 200 PRT Artificial Sequence (Asp30Gln/Ser166Asp/Gln167His) hCNTF sequence from position 1 to position 200 27 Met Ala Phe Thr Glu His Ser Pro Leu Thr Pro His Arg Arg Asp Leu 1 5 10 15 Cys Ser Arg Ser Ile Trp Leu Ala Arg Lys Ile Arg Ser Gln Leu Thr 20 25 30 Ala Leu Thr Glu Ser Tyr Val Lys His Gln Gly Leu Asn Lys Asn Ile 35 40 45 Asn Leu Asp Ser Ala Asp Gly Met Pro Val Ala Ser Thr Asp Gln Trp 50 55 60 Ser Glu Leu Thr Glu Ala Glu Arg Leu Gln Glu Asn Leu Gln Ala Tyr 65 70 75 80 Arg Thr Phe His Val Leu Leu Ala Arg Leu Leu Glu Asp Gln Gln Val 85 90 95 His Phe Thr Pro Thr Glu Gly Asp Phe His Gln Ala Ile His Thr Leu 100 105 110 Leu Leu Gln Val Ala Ala Phe Ala Tyr Gln Ile Glu Glu Leu Met Ile 115 120 125 Leu Leu Glu Tyr Lys Ile Pro Arg Asn Glu Ala Asp Gly Met Pro Ile 130 135 140 Asn Val Gly Asp Gly Gly Leu Phe Glu Lys Lys Leu Trp Gly Leu Lys 145 150 155 160 Val Leu Gln Glu Leu Asp His Trp Thr Val Arg Ser Ile His Asp Leu 165 170 175 Arg Phe Ile Ser Ser His Gln Thr Gly Ile Pro Ala Arg Gly Ser His 180 185 190 Tyr Ile Ala Asn Asn Lys Lys Met 195 200 28 200 PRT Artificial Sequence (Thr169Ile/His174Ala) hCNTF sequence from position 1 to position 200 28 Met Ala Phe Thr Glu His Ser Pro Leu Thr Pro His Arg Arg Asp Leu 1 5 10 15 Cys Ser Arg Ser Ile Trp Leu Ala Arg Lys Ile Arg Ser Asp Leu Thr 20 25 30 Ala Leu Thr Glu Ser Tyr Val Lys His Gln Gly Leu Asn Lys Asn Ile 35 40 45 Asn Leu Asp Ser Ala Asp Gly Met Pro Val Ala Ser Thr Asp Gln Trp 50 55 60 Ser Glu Leu Thr Glu Ala Glu Arg Leu Gln Glu Asn Leu Gln Ala Tyr 65 70 75 80 Arg Thr Phe His Val Leu Leu Ala Arg Leu Leu Glu Asp Gln Gln Val 85 90 95 His Phe Thr Pro Thr Glu Gly Asp Phe His Gln Ala Ile His Thr Leu 100 105 110 Leu Leu Gln Val Ala Ala Phe Ala Tyr Gln Ile Glu Glu Leu Met Ile 115 120 125 Leu Leu Glu Tyr Lys Ile Pro Arg Asn Glu Ala Asp Gly Met Pro Ile 130 135 140 Asn Val Gly Asp Gly Gly Leu Phe Glu Lys Lys Leu Trp Gly Leu Lys 145 150 155 160 Val Leu Gln Glu Leu Ser Gln Trp Ile Val Arg Ser Ile Ala Asp Leu 165 170 175 Arg Phe Ile Ser Ser His Gln Thr Gly Ile Pro Ala Arg Gly Ser His 180 185 190 Tyr Ile Ala Asn Asn Lys Lys Met 195 200 

What is claimed is:
 1. A method of treating obesity and diseases associated therewith in a patient comprising the step of administering to said patient an effective amount of a substance that activates the CNTF (ciliary neurotrophic factor) receptor.
 2. The method of claim 1, wherein said substance that activates the CNTF receptor is hCNTF (human ciliary neurotrophic factor) or a mutant thereof.
 3. The method of claim 2, wherein said substance that activates the CNTF receptor is either a polypeptide consisting of the sequence of SEQ ID NOs: 23, 24, 25, 26, 27, 28 or a modified version of SEQ ID NO: 1, wherein said modified version of SEQ. ID. NO. 1 has amino acid positions 159 to 178 replaced with a sequence selected from the group consisting of SEQ ID NO: 2 to SEQ ID NO:
 22. 4. The method of claim 3, wherein said substance that activates the CNTF receptor is said modified version of SEQ ID NO: 1 wherein amino acids 159 to 178 are replaced with SEQ ID NO:5.
 5. A method of treating obesity and diseases associated therewith in a patient comprising the step of providing to said patient an effective amount of DNA coding for hCNTF or mutants thereof.
 6. The method of claim 5, wherein said DNA codes for either a polypeptide consisting of the sequence of SEQ ID NOs: 23, 24, 25, 26, 27, 28 or a modified version of SEQ ID NO: 1, wherein said modified version of SEQ ID NO: 1 has amino acid positions 159 to 178 replaced with a sequence selected from the group consisting of SEQ ID NO: 2 to SEQ ID NO:
 22. 7. The method of claim 5, wherein said DNA codes for a modified version of SEQ ID NO: 1 wherein amino acids 159 to 178 are replaced with SEQ ID NO:
 5. 8. A method of treating a human obese patient comprising the step of administering to said patient an effective amount of a CNTF (ciliary neurotrophic factor) receptor activating substance to cause a weight reduction in said patient.
 9. The method of claim 8, wherein said substance is hCNTF (human ciliary neurotrophic factor) or a mutant thereof.
 10. The method of claim 9, wherein said substance is either a polypeptide consisting of the sequence of SEQ ID NOs: 23, 24, 25, 26, 27, 28 or a modified version of SEQ ID NO: 1, wherein said modified version of SEQ ID NO: 1 has amino acid positions 159 to 178 replaced with a sequence selected from the group consisting of SEQ ID NO: 2 to SEQ ID NO:
 22. 11. The method of claim 10, wherein said substance is said modified version of SEQ ID NO: 1 wherein amino acids 159 to 178 are replaced with SEQ ID NO:
 5. 12. The method of claim 8, further comprising the use of leptin in an amount sufficient to synergistically enhance weight reduction.
 13. The method of claim 12, wherein said substance is hCNTF (human ciliary neurotrophic factor) or a mutant thereof.
 14. The method of claim 13, wherein the ratio of said hCNTF or said mutant thereof to leptin is 1:500 to 1:5.
 15. The method of claim 14, wherein said ratio is 1:100 to 1:25.
 16. The method of claim 8, wherein said weight reduction is primarily due to a loss of body fat.
 17. The method of claim 9, wherein said weight reduction is primarily due to a loss of body fat.
 18. The method of claim 10, wherein said weight reduction is primarily due to a loss of body fat.
 19. The method of claim 8, wherein said patient has diabetes mellitus.
 20. The method of claim 9, wherein said patient has diabetes mellitus.
 21. The method of claim 10, wherein said patient has diabetes mellitus.
 22. The method of claim 16, wherein said patient has diabetes mellitus. 